Charting moral psychology’s significance for bioethics
Routes to bioethical progress, its limits, and lessons from moral philosophy Klenk, Michael DOI 10.33392/diam.1520 Publication date 2020 Document Version Final published version Published in
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Citation (APA)
Klenk, M. (2020). Charting moral psychology’s significance for bioethics: Routes to bioethical progress, its limits, and lessons from moral philosophy. Diametros, 17(64), 36-55. https://doi.org/10.33392/diam.1520 Important note
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– Michael Klenk –
Abstract: Empirical moral psychology is sometimes dismissed as normatively insignifi cant because it plays no decisive role in settling ethical disputes. But that conclusion, even if it is valid for normative ethics, does not extend to bioethics. First, in contrast to normative ethics, bioethics can legitimately proceed from a presupposed moral framework. Within that framework, moral psychology can be shown to play four signifi cant roles: it can improve bioethicists’ understanding of (1) the decision situation, (2) the origin and legitimacy of their moral concepts, (3) effi cient options for implementing (legitimate) decisions, and (4) how to change and improve some parts of their moral framework. Se-cond, metaethical considerations suggest that moral psychology may lead to the radical revision of entire moral frameworks and thus prompt the radical revision of entire moral frameworks in bioethics. However, I show that bioethics must either relinquish these radical implications of moral psychology and accept that there are limits to progress in bioethics based on moral psychology or establish an epistemic framework that guides radical revision.
Keywords: b ioethics; moral psychology; debunking arguments; metaethics; interdisciplinarity; ac-tivism
Published online: 30 June 2020
In 1997, Dolly, the cloned sheep, captured the public’s imagination. Some scholars re-corded strong emotional aversions to the possibility of human clones, which then seemed within reach, and brought their emotional reactions to bear on the debate about the moral permissibility of cloning. The legal scholar William Ian Miller wrote:1
I am, it should by now be clear, disgusted, even revolted by the idea of cloning: not just the idea of cloning humans, but the idea of cloning sheep too. I am quite frankly disgusted by Dolly…
Michael Klenk
Delft University of Technology Jaffalaan 5
2628 BX Delft The Netherlands
email: M.B.O.T.Klenk@tudelft.nl
Miller’s disgust at cloning guided his normative argument against it. Leon Kass (1997) famously defended the normative signifi cance of disgust – there is “wisdom in repugnance”, he argued.2 Remarkably, Kass claimed that an empirical fact (the fact that
Miller felt disgusted) had normative signifi cance in a bioethical debate.
Kass’s willingness to consider psychological facts as normatively signifi cant would be well received in contemporary moral philosophy. Experimental moral philos-ophers and psychologists are revealing how people make and experience moral judge-ments using a variety of empirical methods such as observations, experijudge-ments, and brain imaging, to name but a few. Some scholars maintain that some such moral psychological fi ndings question the trustworthiness and authority of many intuitive ethical responses3
or undermine particular philosophical theories about the nature of morality.4
At the same time, anyone remotely familiar with moral philosophy will be aware of warnings against deriving an ‘ought’ from an ‘is’. The fact that things are, or have been, a particular way does not settle the question of how they ought to be. Consequently, the rise of empirical moral psychology brought with it a lively debate about its normative signifi cance in moral philosophy (normative ethics and metaethics), where a ‘sceptical’ view has taken hold. In normative ethics, the normative signifi cance of empirical fi ndings is vehemently disputed because arguments that invoke moral psychology can be shown to ultimately require controversial normative assumptions too.5 In metaethics, the debate
about the extent to which moral psychology has radical revisionary implications (to wit, its potential for changing fundamental presumptions about morality) can be shown to depend on unresolved epistemological questions.6
However, at present, there is no overarching framework that organises and explains the normative signifi cance of empirical moral psychology for bioethics more generally in light of the debate in moral philosophy. Of course, there is substantial work on the signifi cance of moral psychology for particular cases7 and attempts to classify the
impact of empirical work on bioethics.8 But these contributions either do not address the
signifi cance of moral psychology on a systematic level or fail to take into account recent lessons from moral philosophy.
In this paper, I apply insights from the moral philosophical debate to the recent discussion about the normative signifi cance of moral psychology for bioethics to or-ganise and illuminate the “clouded relations” between bioethics and empirical moral psychology.9 I chart the normative signifi cance of moral psychology for bioethics by
describing what moral psychology can and cannot do for bioethics. On the positive side, I defend four concrete, signifi cant uses of moral psychology in bioethics. Importantly, I will show that these uses are legitimate and signifi cant for bioethics even if sceptical arguments about the normative insignifi cance of moral psychology in normative ethics
2 Kass (1997).
3 Greene (2014); Sinnott-Armstrong (2006). 4 E.g. Haidt (2001); Prinz (2007).
5 E.g. Berker (2009); Clipsham (2014); Paulo (2019). 6 Klenk (2018); Wielenberg (2016).
7 E.g. May (2016a; 2016b).
8 E.g. Musschenga (2005); Kon (2009); Vries, Gordijn (2009). 9 Borry, Schotsmans, Dierickx (2005).
succeed. On the negative side, I will argue that the normative signifi cance of moral psy-chology for bioethics is limited by raising a challenge that is informed by recent insights from moral philosophy. In short, in moral philosophy, moral psychology may lead to a radical revision of entire moral frameworks. However, bioethics must either relinquish the radical implications of moral psychology or establish an epistemic framework that guides radical revision.
The paper is structured as follows. In section 1, I establish some common ground and introduce key terms used in the debate. In section 2, I recap sceptical arguments to the effect that moral psychology is normatively insignifi cant in normative ethics. I accept this sceptical conclusion for the sake of argument and then show, in section 3, that it does not extend to bioethics. Hence, even if moral psychology is insignifi cant for normative ethics, it may be signifi cant for bioethics. In section 4, I demonstrate that moral psychology can indeed play a highly signifi cant role within the normative frameworks presupposed by bioethics. I describe and defend four concrete ways in which moral psychology is normatively
signifi cant for bioethics. Finally, in section 5, I describe the limits of using moral psychology
in bioethics. In short, moral psychology may provoke us to change some or all of our moral principles or decision guidelines. Radical revision, i.e. changing all moral principles or decision guidelines, would lead to the most consequential impact of moral psychology on bioethics. However, I argue that this use of moral psychology is out of reach for bioethics. The paper thus connects recent fi ndings from ‘theoretical’ moral philosophy (comprising normative ethics and metaethics) with bioethics and should be of interest to anyone concerned with the scope of the normative signifi cance of moral psychology for bioethics.
1. Bioethics and moral psychology
Before turning to the central part of the argument, it is essential to clarify its principal terms. In particular, I explain the signifi cance of considering bioethics as a practically
com-mitted discipline and defi ne ‘empirical moral psychology’ and ‘normative signifi cance’
for the purposes of this paper.
In his article ‘From Metaethicist to Bioethicist’, Baker (2002) describes one of the core aspirations for the founders of bioethics: to escape the minute theoretical squabbles of disciplinary philosophy and instead to turn to issues of practical import.10 Bioethics
shares its practical orientation with subfi elds of practical ethics, which arose as a response to increasing neoliberal demands to demonstrate the societal relevance of academic research.11 Bioethics, as well as environmental ethics, engineering ethics, and computer
ethics, thus aims to make an impact beyond the confi nes of academic journals, and this is evident in virtually all self-descriptions of bioethics.12
However, in an insightful article that addresses the development and success of practical ethics, Frodeman Briggle, Holbrook (2012) suggest that bioethics is not only
practically oriented, like other subfi elds of practical ethics, but what might be called prac-10 Baker (2002); cf. Callahan (1973).
11 Frodeman, Briggle, Holbrook (2012).
tically committed.13 That means that bioethics primarily aims to effect legitimate decisions
in practice and devotes signifi cant effort to making that happen.14 For example, bioethics
ad-dresses a non-disciplinary audience, i.e. it speaks to non-philosophers and practitioners in the fi eld, it largely avoids a top-down approach where high theory is applied to the decision situation, and it involves a continuous and practical dialectical back and forth between theory and practice.15 Some infer from the practical commitment of bioethics a
professional obligation to engage in or support activism.16 There is some debate, though,
about whether such an obligation exists, and what it entails.17 But need not engage in
that debate in order to infer what bioethics should not do, given its aim: to focus pre-dominantly on what we ought to think at the expense of fi nding out and effecting what we ought to do. We can now ask the question that this paper address in a new way: what is the normative signifi cance of empirical moral psychology for bioethics if it is to be understood as a practically committed discipline?
This leaves ‘empirical moral psychology’ and ‘normative signifi cance’ to be clar-ifi ed further. Empirical moral psychology provides us with particular empirical facts. It is the empirical study of human functioning in moral contexts, specifi cally the study of moral experience and behaviour, its development, and its internal and external causes and conditions.18 It leaves the matter of how to defi ne moral phenomena open, but any
attempt in that direction would be beyond the scope of this paper.
I understand empirical fi ndings as having ‘normative signifi cance’ if those new empirical fi ndings meet two conditions:
1. They challenge our moral principles and decision guidelines or
2. They make a difference to what we ought to do in a given decision situation, insofar as we hold some set of moral principles or decision guidelines fi xed in that decision situation.19
Consider a simple example that illustrates how empirical fi ndings make a dif-ference to what we ought to do in a given decision situation. Suppose that we ought to do only as the law commands. We all assume that the law allows doing x. However, we learn that the law does not allow x. So that piece of information is normatively signifi
-13 Frodeman, Briggle, Holbrook (2012).
14 Naturally, the distinction drawn by Frodeman, Briggle, Holbrook (2012) does not neatly, strictly,
and universally separate bioethics from other fi elds of practical ethics. Still, the distinction provides a useful heuristic for describing the aims of bioethics as a discipline.
15 Frodeman, Briggle, Holbrook (2012). Parallel developments toward practical commitment exist
in other fi elds of practical ethics too. See, for example, the proposal for a practically committed and informed business ethics in Beschorner (2006). Bioethics arguably veered off toward a less practically committed model at times, but, as Borry, Schotsmans, Dierickx (2005) describe, it generally and reliably returned to its practical commitment.
16 See the contributions in Draper, Moorlock, Rogers et al. (2019). 17 Draper (2019); Lindemann (2019).
18 Doris, Stich, Philips (2020). Naturally, this includes work in various (sub)fi elds of psychology and
neuroscience but it also includes some work in the social sciences, notably sociological, (behavioural) economical, and anthropological work that gives us insights into the moral experience and behaviour of people cf. Keane (2016); Curry (2016).
19 Thanks to an anonymous referee for prompting me to clarify this point. As I show below, empirical
cant, because it makes a difference to what we ought to do.20 Similarly, suppose we learn
that what seemed like an x is really a y, and the law forbids doing y. That information is normatively signifi cant as well because it makes a difference to what we ought to do. With these clarifi cations on the table, we can reformulate the guiding question one fi nal time as follows: do the fi ndings of empirical moral psychology make a difference to what one ought to do in bioethics as a practically committed discipline? In what follows, I will show that the answer is ‘Yes’ because negative assessments of moral psychology’s signifi cance for normative ethics do not carry over to bioethics.
2. The normative insignifi cance of moral psychology for normative ethics
Moral psychology has often been used in attempts to settle long-standing normative disputes,21 but normative ethicists have frequently dismissed such attempts. Many are
sceptics about the normative signifi cance of moral psychology.22
To illustrate an argument in normative ethics ‘from moral psychology’ (to wit, an argument that invokes descriptive premises informed by moral psychology), consider a brief outline of the much-discussed anti-deontological argument of Joshua Greene.23
Greene argues, based on fMRI and reaction-time data from experiments, that some types of moral judgements (which he calls “characteristically deontological moral judgements”) are based on predominantly emotional processes. Furthermore, Greene argues that such emotionally-grounded moral judgements are suspicious and should be distrusted.24
The moral philosophical reception of Greene’s argument (and others relevantly like it)25 has largely been sceptical, in the sense that the normative signifi cance of moral
psychology is dismissed.26 It can be shown that Greene’s anti-deontological conclusion
depends on normative intuitions about what counts as morally irrelevant factors.27 Thus,
Greene’s argument can be summarised as follows:
1. A set of descriptive premises that invoke moral psychology. 2. A set of moral premises.
3. A moral conclusion.
20 Concerning ‘ought’, objectivists can assume that we learn an objective truth when we learn that
the law does not allow x.
21 E.g. Ruse, Wilson (1986); cf. Paulo (2019). 22 Berker (2009).
23 Greene (2008; 2014), Greene, Sommerville, Nystrom et al. (2001). 24 Greene (2014).
25 Similar examples concern consistency reasoning, cf. Campbell, Kumar (2012), and the debate about
the normative signifi cance of disgust, cf. Kelly (2011).
26 Some have interpreted Greene’s argument ‘from moral psychology’ as an attempt to uproot a
philo-sophical, normative view (deontology, in Greene’s case) from purely descriptive, moral psychological bases. Such an interpretation is uncharitable because it would ascribe to proponents of such arguments an illegitimate crossing of the is–ought gap. Arguments of this kind are primarily responsible for the ‘dreadful reputation’ enjoyed by empirical moral psychology in some philosophical circles today, al-though inferring an ‘ought’ from an ‘is’ via an implicit or explicit normative premise is commonplace (cf. Doris, Stich, Philips et al. (2020). See Vries, Gordijn (2009) for a relevant discussion in bioethics.
27 Paulo (2019). See Klenk (2019b) for a meta-analysis of the situational factors at play in sacrifi cial
Hence, Greene’s normatively signifi cant conclusion that deontological judgements ought to be distrusted is informed by moral psychology. But it ultimately and crucially depends on philosophical, normative intuitions. Because of the ultimate importance of certain normative assumptions in arguments ‘from moral psychology’, several scholars have argued that moral psychology does little important work in these arguments.28
Ul-timately, the argument goes, moral psychology does not help us fi nd out what we ought to think about morality without presupposing some important normative premises itself. Therefore, moral psychology has frequently been taken to be normatively insig-nifi cant for normative ethics. Though the validity of the sceptical conclusion merits fur-ther discussion, I will assume it for the sake of argument. My focus will be on assessing whether it carries over to bioethics and the answer will be ‘No.’
3. Moral psychology works for bioethics, even if it fails in normative ethics
I now demonstrate that sceptical assessments of moral psychology’s signifi cance in normative ethics do not extend to bioethics. So, even if it is true that moral psychology is normatively insignifi cant for normative ethics, moral psychology can still be normatively
signifi cant for bioethics.29
The inclusion of moral premises leads to the dismissal of moral psychology as ultimately normatively signifi cant in moral philosophy. Understanding why that is the case will help us see why the same sceptical conclusions do not extend to bioethics.
Normative ethicists are primarily concerned with what we ought to believe about morality. For example, consider G.A. Cohen’s characterisation of normative philosophy as being concerned “not with what we should do but what we should think, even when what we should think makes no practical difference.”30 Irrespective of the sensibility of
such an approach to normative ethics, the commitment to determining what we should think explains the verdict that moral psychology is normatively insignifi cant for normative ethics.31 Normative assumptions about what we should think are required in an argument
from moral psychology, but those assumptions are precisely what normative ethics aims to scrutinise. Assuming the disciplinary aims of normative ethics – as set out by Cohen – the dismissal of moral psychology may seem reasonable from a normative ethics perspective. However, the sceptical conclusion about the normative signifi cance of moral psychology does not extend to bioethics. First, bioethics is primarily concerned with what ought to be done, rather than what we ought to think (as discussed in section 1 above).
28 Paulo (2019); Berker (2009); Clipsham (2014).
29 Useful critical interpretations of the sceptical conclusion that I will assume for the sake of argument
can be found in Hopster (2018) for an argument in metaethics and in Lindauer (2019) for normative ethics more generally.
30 Cohen (2003).
31 One need not accept, however, that normative ethics is primarily about what one ought to think.
It is sensible to suppose, for example, that learning how to do what one ought to do is also a part of normative theorising (as an anonymous referee suggested). Insofar as one assumes this more inc-lusive picture of normative theorizing, one could nonetheless follow my analysis in sections 3 and 4, but my challenge regarding unleashing the full potential of empirical moral psychology presented in section 5 would still stand.
Second, as Childress (2007) argues, bioethics virtually always operates within a frame-work of normative assumptions about applicable moral principles,32 rules,33 virtues, or
strategies for “moral diagnosis” in casuistry approaches.34 Notwithstanding the
impor-tant differences between these different approaches, I will use ‘normative commitment’ or ‘normative framework’ as umbrella terms to refer to the normative assumptions that guide bioethical work. As methodological discussions about adequate approaches to bio-ethics indicate,35 there is a sense in which a given framework may be better than another,
even if there is no single best framework. Within such a framework, moral psychology can make a tremendous difference to what ought to be done in a bioethical case.
Therefore, bioethicists should not accept the sceptical conclusion about the sig-nifi cance of moral psychology from normative ethics. On the contrary, bioethics has much to gain from moral psychology, precisely because it can often make a difference to what ought to be done in a bioethical case, which means that moral psychology is normatively signifi cant for bioethics.
4. Four signifi cant uses of moral psychology in bioethics
Moral psychology can be highly signifi cant for bioethics. To illustrate this point, con-sider an analogy with an internet search engine, like Google Search. The results of your search query depend on two factors: Google’s database (i.e. all website content indexed by Google) and the algorithm for identifying, ranking, and presenting matches within the database with your query. Most of the time, Google Search works pretty well. That is, until you are looking for something that is not in the database. For example, suppose Ken Kunz the trapper lives off the grid in Alaska and has thus far managed to leave no trace of himself online or offl ine. Try looking him up on Google – you will fi nd nothing on that Ken Kunz, and no fi xing of Google’s search algorithm can change that. Instead, new information must be added to the database.
Likewise, bioethicists require adequate factual information to answer bioethical questions.36 In recognising the importance of descriptive facts for bioethics, and
acknowl-edging the analogy with a search engine, one need not assume that there is a unique set of truths about physical or social reality that moral psychology describes, nor that there is a unique method used in bioethics. There can be various equally viable bioethical approaches, but as pointed out above, all of them will operate within certain normative assumptions (analogously, according to the search engine’s algorithm) that guide the evaluation of the case (analogously, according to the search engine’s database).
Having defended in the previous section the negative conclusion that scepticism about moral psychology does not extend from normative ethics to bioethics, I will now defend some positive points. I will systematise and distinguish four different ways in which moral psychological insight is normatively signifi cant in bioethics.
32 E.g. Beauchamp, Childress (2013); Beauchamp, Rauprich (2016); Veatch (1981). 33 Clouser, Gert (1990).
34 E.g. Jonsen, Toulmin (2012); cf. Arras (1991). 35 E.g. Ives, Draper (2009); Singer, Viens (2008). 36 Düwell (2013).
4.1. Actual-state analysis
Moral psychology increases our understanding of the non-moral facts that are relevant to a bioethical decision. I will refer to this as ‘actual-state analysis’ because bioethicists can use moral psychology to more accurately understand the actual or current state of a decision situation.
For example, van Thiel & van Delden (1997) use qualitative measures to establish the extent to which Dutch nurses act in compliance with the demands of patient autono-my.37 Duke & Thompson (2007) use quantitative measures to uncover the preferences of
patients in end-of-life care.38 Such uses of moral psychology are highly signifi cant because
bioethical judgements are always mixed judgements that are based on both normative and empirical presuppositions.39 To verify the truth of the empirical presuppositions,
em-pirical moral psychology provides bioethicists with a powerful extension of their means for accurately examining the descriptive facts of a bioethical case. Several fi ner-grained distinctions within the category of actual-state analysis are possible.40 What unites them
is the recognition that moral psychology can signifi cantly inform how to orient one’s normative framework to a given bioethical case, which underwrites the point that moral psychology is normatively signifi cant for bioethics.
4.2. Genealogical analysis
The use of moral psychology in what I have dubbed ‘actual-state analysis’ may be fa-miliar territory. But there is more. Bioethics can also use moral psychology to focus on backwards-looking components and, in particular, on facts about the ultimate or prox-imate genealogy of our moral judgements. I will refer to this as ‘genealogical analysis’ because bioethicists can use moral psychology to understand where their own moral judgements and moral dispositions, or those of other people involved in the decision situation, come from. For example, some studies make hidden psychological infl uences available for normative inquiry.41
In an illustrative example, Żuradzki (2019), discusses the so-called identifi able victim effect, which is the psychological fi nding that people are more eager to help identifi ed individuals than unidentifi ed ones.42 For example, people seem more willing
to donate money to help an identifi ed patient than to donate money to a hospital. So whether a victim is identifi able or not often makes a difference regarding people’s moral judgements (or so it seems). But is it legitimate to base one’s moral judgements on this factor? Several philosophers have argued that the identifi ability of a patient is norma-tively insignifi cant, all else being equal. Hence, deciding for or against an action based on the identifi ability of the patient would be illegitimate. Empirical moral psychology can make these hidden infl uences on moral judgement available for inquiry.
37 van Thiel, van Delden (1997).
38 Duke, Thompson (2007). See also Musschenga (2005); Herrera (2008); Vries, Gordijn (2009). 39 Düwell (2013).
40 Cf. Vries, Gordijn (2009); Musschenga (2005); Kon (2009). 41 Żuradzki (2019, 2015); Brinchmann, Nortvedt (2001).
Genealogical analysis obviously contributes to a full understanding of the actual state. It is expedient to single it out as a separate category nonetheless, because gene-alogical analysis comes as a corrective second step after an initial assessment of the actual state has been made. Its focus is to uncover infl uences on thought and behaviour that seem illegitimate in light of the chosen normative framework and thus need to be removed from consideration.
4.3. Forward-looking analysis
There are also forward-looking components, where bioethicists can use non-moral facts about how to improve practical bioethical interventions. I refer to this as ‘forward-look-ing analysis’, because bioethicists can invoke moral psychology to analyse and better understand how to put bioethically legitimate decisions into practice (i.e. how to proceed from the point at which a decision has been taken). The effectiveness and realisability of bioethical decisions depend to a signifi cant degree on moral psychological factors, and bioethicists should make use of insights from moral psychology to seek ways to put into practice what ought to be done.
For example, Antiel, Humeniuk, Tilburt (2014) discuss research about the be-havioural effects of moral disagreement and ways to overcome them.43 They show that
appealing to the moral foundations by a patient helps to make the patient behave in desired ways. Insofar as we have moral obligations to intervene in specifi c ways, moral psychology can tell us how to do it best.44 So by having a fi xed set of moral principles
that tell us what we want to achieve by means of a bioethical intervention, moral psy-chological premises can tell us how we ought to do it.
Lindauer (2019) has recently discussed several additional forward-looking uses of moral psychological fi ndings.45 Among those, a particularly interesting suggestion is
that the normative concepts used by people can play a practically relevant role. Lindauer writes (2019):
The point is to see which concepts and arguments, that at least some reasonable interlocutors take to be good ones, do the best job of helping us to solve practical problems.
That suggestion meets the practical commitment of bioethics, and it fi ts into the larger category of using moral psychology for forward-looking analysis in bioethics. That concepts do indeed have practical consequences is shown, for example, in recent work on people’s evaluations of social interactions, which are signifi cantly (negatively) infl uenced by descriptions that invoke concepts associated with online technology (ref-erence redacted for blind review). Bioethical interventions aimed at, for example, getting
43 Antiel, Humeniuk, Tilburt (2014).
44 See also Dörries (2009) and Wocial (2010), who have described similar useful interventions based
on moral psychological insights in this journal.
people to refrain from such interactions, could use such fi ndings to improve their effi cacy (given a sound bioethical legitimation for the intervention, of course).46
Forward-looking analysis is thus helpful to determine how to best carry out a bioethical decision. Given bioethics’ practical commitment, successful implementation is an important aim. The contrast with normative ethics and its primary focus on what to
think is especially clear here. Even if moral psychology has no effect on what we ought to
think about moral matters, it is surely signifi cant for how we ought to do what we ought to do and thus normatively signifi cant in the sense defi ned above.
4.4. Restricted fundamental revision
Thus far, I have described how empirical moral psychology can be normatively signif-icant in the sense of making a difference to what we ought to do while holding fi xed some set of moral principles or decision guidelines.47
However, moral psychology can also lead us to revise at least some of our moral principles or decision guidelines. In this most profound sense, we can use moral psy-chology to change our warranted confi dence in some parts of our normative framework. I will refer to this as ‘restricted fundamental revision’. Moral psychology can lead to
fundamental revision in the sense that it alters the parts of a normative framework that are
used for bioethical decision making. As discussed in section 2, bioethics proceeds from some sort of normative framework or commitments (whether they are rules, principles, or virtues, etc.). Changing some of the parts of such frameworks or commitments (e.g. by warranting reduced confi dence in a particular principle) is what I call fundamental revision. Moral psychology can lead to fundamental revision but it will be restricted in the sense that it cannot change our warranted confi dence in all parts of the normative framework. But as long as bioethicists hold at least some parts of the normative frame-work fi xed, they can build arguments that typically lead to reduced confi dence in other aspects (beliefs and judgements) of the normative framework that we currently accept. For example, consider the revision of the strong interpretation of autonomy, according to which patients uniformly prefer to take all decisions themselves, in bio-ethics.48 Several lines of moral psychological inquiry, both quantitative and qualitative,
have contributed to the insight that the strong interpretation of autonomy is based on faulty empirical presuppositions.49 This analysis is possible because it is based on another
aspect of the normative framework that is held fi xed, namely that patients’ preferences regarding self-legislation should be respected. Based on this ‘common ground’, a restricted fundamental normative revision based on moral psychology was possible and legitimate.
46 Lindauer’s aim is that his discussion is understood as a general vindication of empirical moral
psy-chology in normative ethics. Insofar as his project succeeds, it would vindicate the four uses of moral psychology discussed in this section. Nevertheless, I would still maintain that Lindauer’s argument fails to vindicate the project of unrestricted fundamental revision in normative ethics. Whether that is signifi cant, of course, is ultimately a question about the proper aims of normative ethics, which is a discussion well beyond the scope of this paper.
47 This is the second sense of normative signifi cance discussed in section 1. 48 Kon (2009).
In light of this limited revisionary use, empirical moral psychology may help bioethicists to not only ‘enrich the database’ of normatively-relevant non-moral facts (as described above) but also to partially revise their normative framework. Moral psy-chology can thus change bioethical normative frameworks and therefore also change what people ought to do in bioethical contexts. Therefore, moral psychology has a high level of normative signifi cance for bioethics within the limits of at least some parts of a normative framework.
5. The challenge of unleashing the full potential of moral psychology
Thus far, I have argued that sceptical conclusions about the normative signifi cance of moral psychology should not be projected from moral philosophy to bioethics, and I distinguished four concrete ways in which moral psychology can play a signifi cant role for bioethics.
In this section, I will draw a second lesson from moral philosophy and consider whether unrestricted fundamental revision based on moral psychology is possible in bioeth-ics. Recall that fundamental revision means that some parts (e.g. principles or rules) of a normative framework can be changed by moral psychological fi ndings. Asking about
unrestricted fundamental revision is asking whether moral psychology could change all of a given normative framework. Though unrestricted fundamental revision is possible
and highly rewarding in moral philosophy, there are signifi cant challenges to making use of this instrument in bioethics.
What is unrestricted fundamental revision? To illustrate and explain the idea, recall the analogy with an internet search algorithm. Even with a wonderfully detailed database, the results of a search engine will be only as good as the search algorithm. For example, although Google Search has a tremendously rich database, problems in the search algorithm can limit its usefulness. For instance, a while ago, Google image searches for ‘CEO’ only turned up pictures of white men, and general search results produced prestigious job ads for men, but not for women.50 If the algorithm is not fi xed,
enriching the database will not resolve the problem. Likewise, the added understanding provided by moral psychology (in terms of actual-state, forward-looking, genealogical, or restricted fundamental analysis) is only fully useful for bioethics insofar as is pos-sesses an adequate moral framework to begin with. Recall that we need not assume that there is a single best moral framework or that a moral framework necessarily consists of fi xed moral principles. It suffi ces to assume that some moral frameworks can be better than others, and virtually all contemporary bioethical methodologies are based on this assumption.51
The next section will show how such unrestricted fundamental normative revi-sion is possible, highly attractive, and yet very controversial in metaethics. I will then argue in the section that follows that the controversiality of unrestricted revision raises a methodological challenge for bioethics.
50 Kay, Matuszek, Munson (2015). 51 Cf. Childress (2007).
5.1. Unrestricted fundamental revision in metaethics
Empirical moral psychology may be used for unrestricted fundamental revision in meta-ethics. That is, its fi ndings can be used to challenge fundamental assumptions about our justifi cation for maintaining some or all of our moral beliefs. In contrast to the restricted revision discussed above, unrestricted revision does not depend on a (set of) moral prem-ises to yield a valid argument.
In this section, I will demonstrate unrestricted fundamental revision in metae-thics in some detail to show with some clarity where the epistemic problems for such arguments arise. This will be helpful to see how such arguments raise a challenge for bioethics in the next sub-section.
For example, consider a conventional interpretation of so-called evolutionary
debunking arguments in metaethics.52 These arguments are supposed to show that
our confi dence in all our moral judgements is undermined by the fact that our moral judgements (ultimately) have an evolutionary explanation. Since moral judgements are adapted to increase fi tness, and insofar as fi tness is unrelated to moral truth,53 it would
be a coincidence if our moral judgements were true. Hence, we ought to give up our moral judgements, or so the argument goes.
This reconstruction of an evolutionary debunking argument is oversimplifi ed in many ways, but the crucial point is preserved. There is a jump from an empirical claim, namely that evolutionary infl uences could easily have led us to endorse different moral beliefs, to an epistemic claim, namely that we therefore epistemically ought to give them up.54 In general, these arguments proceed as follows:
1. A set of descriptive premises that invoke moral psychology. 2. A set of epistemic premises.
3. A morally signifi cant conclusion.
This sketching out of these arguments can be turned into a valid argument that avoids the is–ought fallacy because it includes at least one normative premise. In con-trast to the sketching out of our earlier argument, however, the normative premise is of the epistemic and not the moral kind. Attempts at unrestricted revision based on moral psychology have invoked evolutionary considerations as well as (social) psychological,55
neuroscientifi c,56 and anthropological ones.57 The conclusion of these attempts is morally
signifi cant because it states that (particular) moral beliefs ought to be given up or that we have reason to change our beliefs about the status of morality.
However, it can be shown that epistemic considerations that could lead us to funda-mentally revise our moral outlook are fraught with controversy to the extent that attempting an unrestricted revision ‘from moral psychology’ requires engaging in an epistemological argument. Two main arguments for unrestricted revision have emerged in the literature.
52 Cf. Kahane (2011); Sinclair (2018); Wielenberg (2016); Joyce (2016a); Klenk (2018).
53 To illustrate, consider that providing for unrelated people may be morally right but not fi
tness-en-hancing, cf. Buchanan, Powell (2015).
54 Cf. Klenk (2020a) for more details and an overview of the discussion. 55 Leiter (2004a).
56 Sinnott-Armstrong (2008). 57 Brandt (1944).
The fi rst route employs the principle of parsimony: insofar as some moral psy-chological theory can (best) explain why people hold a moral belief B, one is not justi-fi ed in assuming the existence of some moral fact as a referent of the belief. Hence, one can conclude that there are no such moral facts.58 However, the principle of parsimony
is controversial in arguments about what we ought to believe. Suppose that you have good reason to believe in some type of bioethical framework, such as the principle of autonomy. Attempts at unrestricted revision suggest that you ought to change your belief once you discover that your endorsement of the belief is not explained by its truth (or adequacy). But that is a bona fi de epistemological claim, and it is far from settled whether we have reason to accept it. Consequently, the major discussion point concerning such arguments is not whether moral psychology provides the best explanation of some moral phenomenon (that is widely accepted, though see Buchanan & Powell, 2015), but whether that fact has any epistemological import. Hence, the fi rst route to an unrestrict-ed fundamental normative revision leads straight into a deep epistemological thicket.
The major alternative employs a premise about the epistemic justifi cation for maintaining and changing moral beliefs.59 This route to unrestricted fundamental
nor-mative revision requires showing that moral beliefs lack justifi cation, given some moral psychological fact, where the lack of justifi cation does not stem from the explanatory ineffi cacy of moral facts (as in the previous option). The argument would follow this schema: ‘the A-judgements are based on E, and E is epistemically non-warranting, and therefore the A-judgements are not warranted’. In this case, we would have a bona fi de argument for unrestricted fundamental revision. However, we would again have bona fi de epistemological claims to discuss. Why is an E-based belief not warranted? And, if it is not warranted, why ought it be given up?
Like in the previous parsimony-based argument, the major discussion point of arguments that follow this route does not concern the moral psychological facts, but rather their epistemic signifi cance.60 Legitimately accepting an unrestricted fundamental
normative revision therefore entails a legitimate epistemic argument.
There are thus signifi cant epistemic and methodological challenges for successful unrestricted fundamental revisions in metaethics. Overcoming these challenges may be extremely rewarding. In contrast to restricted fundamental revisions, unrestricted fundamental revisions might make good on the promise that arguments from moral psy-chology can settle or improve long-standing philosophical disputes that are entrenched because they are based on differing moral starting assumptions.
5.2. Limits of unrestricted fundamental normative revision in bioethics
There could be a similar attempt at unrestricted fundamental normative revision in bioethics. As discussed above, bioethics relies on some kind of normative framework (which, depending on the details, invokes principles, rules, values, virtues, or basic value orientations in casuistry approaches). Unless one employs a widely implausible (indeed
58 See also Harman (1977). 59 Cf. Klenk (2019a; 2020b). 60 Wielenberg (2016).
incoherent) ‘anything goes’ approach to bioethical decision making, one will therefore have to accept that there is a sense in which one’s chosen normative framework could be improved (even if there is no single best normative framework).61
From that perspective, bioethicists can sensibly ask the following question: do we have the right framework? Are we justifi ed in using that framework (as opposed to some other framework)? Recall our analogy with a search engine. We can ask ‘Could we have a better search algorithm that processes all that information and spits out an answer?’ Analogously, ‘Could we have a better framework to process all that information and come to answers to bioethical cases?’ If the answer is yes, then there is room to improve (bio)ethical thought and behaviour.
Indeed, it is not only sensible for bioethicists to be concerned with unrestricted fundamental revision, but also obligatory. At least, insofar as bioethicists make the plausible assumption that there can be better and worse bioethical decisions and that their chosen normative framework signifi cantly infl uences their success in arriving at better bioethical decisions. The fact that there is already signifi cant methodological debate within bioethics – about the adequate or suitable normative framework (in the loose sense defi ned above) – is evidence that bioethicists (rightly) take that obligation seriously. Moral psychology could play a signifi cant role in making progress in these debates by fi guring in an argument for unrestricted fundamental revision.
It is important to emphasise the unrestricted nature of the attempted revision. Oth-er bioethicists have already discussed how moral psychology may be used to ‘formulate’ ethical principles in biomedicine,62 which may create the impression that what I have
called a normative framework is built from the ground up on moral psychology. On a closer look, however, such attempts actually begin with normative, moral assumptions about moral relevancy and then formulate moral principles that meet those assumptions and also fi t well with moral psychological insights. The result is a restricted revision, however, because it relies on at least some moral premises. Unrestricted revision does without them altogether.
However, the open epistemological questions raised by attempts at unrestricted fundamental revision pose a signifi cant challenge for bioethics. The normative episte-mological premise leaves open the matter of why a (set of) moral belief(s) ought to be abandoned. In short, showing that some moral beliefs, B, ought to be abandoned because some process, x, infl uences them, requires showing that all x-infl uenced beliefs ought to be given up. But showing ‘that all x-infl uenced beliefs ought to be given up’ will require an epistemological argument.
This is a problem for bioethics insofar as it lacks an established (number of)
epis-temic frameworks that could guide the required episepis-temic decision making in light of
attempts at unrestricted fundamental normative revision. Unlike in the case of restricted fundamental normative revision, where bioethicists can assume premises from a given normative framework and then use moral psychology to derive a normatively signifi cant conclusion, bioethicists cannot lean on an uncontroversial set of epistemic premises to
61 Childress (2007).
derive a normatively signifi cant conclusion from an argument aimed at unrestrictive fundamental revision. Of course, the normative assumptions in arguments aimed at restricted fundamental normative revisions will probably be controversial in normative ethics (after all, there is no settled normative ethics in sight), but that does not matter given the internal commitments of bioethics. The problem is that such internal commit-ments about epistemology are lacking, and that means that bioethics cannot make use of unrestricted fundamental normative revision.
Naturally, bioethicists could engage in the epistemic debate and defend one or the other epistemic solution to make moral psychology work in unrestricted fundamen-tal normative revision. But that seems to confl ict with the practical commitment (rather than mere practical orientation) of bioethics as a discipline. According to Frodeman, Briggle (2016), what makes bioethics successful as a fi eld of practical ethics is its disci-plinary intertwinement with its fi eld of study.63 Bioethicists not only study and write
about bioethical cases, they are actively involved in bioethical decision making and the translation of those decisions into practice. In contrast, engaging in epistemology as an inquiry into what we ought to believe is in some sense removed from an interdisciplinary audience and practical concerns. Pursuing unrestricted fundamental normative revision would thus betray the practical commitment of bioethics. Moreover, as others have shown,64 it is often unrealistic to hope that developments in one discipline will somehow
arrive and take hold in neighbouring disciplines without concrete measures that support such cross-fertilisation. Assessing the normative signifi cance of moral psychology for bioethics thus reveals a lacuna concerning the methodological relations between (moral) epistemology and bioethics.
There are two options in light of this lacuna. First, bioethicists could simply avoid such arguments. But there is a sense in which this would imply a moral failing. After all, once we assume (plausibly) that there are better and worse bioethical decisions and that one’s chosen normative framework signifi cantly determines the outcome, we are committed to searching for the best available normative framework. Missing an oppor-tunity to invoke moral psychology in this task would be a failing. Importantly, even a very general conclusion about the nature of our normative frameworks in bioethics that is drawn from moral psychology would require facing the epistemic challenge outlined above. For example, some may suggest that moral psychological research may have implications on a more general level since it invites us to view morality in pragmatic terms, presumably because moral psychology teaches us about the fragility of moral judgements. But that route is not available for bioethicists without engaging the ques-tions raised by using moral psychology in unrestricted fundamental normative revision. Adopting, for example, a pragmatic perspective on ethics is to adopt a metaethical theory. But to adopt that theory on legitimate grounds, one needs good reasons to do so, and those arguments leave us with open questions about whether we have such reasons or not. The matter can, of course, be settled by stipulation, choice, or vote – but it would be doubtful that such procedures would be legitimate, and the legitimate choice of our
63 Frodeman, Briggle (2016).
moral principles is what bioethicists strive for. Therefore, avoiding or ruling out from the start the use of moral psychology for unrestricted fundamental normative revision is not a good option.65
Instead, the implications of the foregoing arguments are that bioethicists need come up with a canon of basic epistemic principles for bioethics. That is the challenge that arguments for unrestricted fundamental normative revision based on empirical moral psychology confront us with. The point can be illustrated by going back to the compari-son between moral psychology’s use in normative ethics and its use in bioethics. Moral psychology works for bioethics, but probably not for normative ethics, because bioethics can legitimately presuppose some normative framework in light of its disciplinary aims. Within that framework, moral psychology can have normatively signifi cant implications. But aiming for unrestricted fundamental normative revision requires normative frame-works, too, only epistemic ones rather than moral ones. An epistemic framework would allow bioethicists to evaluate moral psychology’s signifi cance for changing or revoking their moral assumptions and thus for changing their moral framework. The methodo-logical challenge for bioethics is to evaluate how developing such a framework can be squared with its practical commitment. Given the aforementioned defence of the impor-tance of adequate moral frameworks, however, an inquiry into the possibility of bioethics establishing an epistemic framework is well worth having, though, unfortunately, it is well beyond the scope of this paper. The upshot of the discussion in this section is that the potential normative signifi cance of moral psychology (for unrestricted fundamental normative revision) causes a challenge for bioethics: which epistemic framework can inform the use of moral psychology in bioethics? Given the importance of adequate moral frameworks in bioethical decision making and the potential to change or improve those frameworks through radical revision, it is a challenge to be taken seriously.
Moral philosophical engagement with moral psychology thus offers two quite distinct lessons for bioethics. Within the scope of a normative framework, moral psy-chology is normatively signifi cant in bioethics even if it is not in in moral philosophy. Without an epistemic framework to lean on, however, moral psychology does not legit-imately reach its most radical normative potential for bioethicists.
6. Conclusion
I have outlined a theory about the normative signifi cance of moral psychology in bio-ethics by analysing two lessons from moral philosophy. First, though moral psycholo-gy may be normatively insignifi cant if viewed in light of the aims of normative ethics, that conclusion does not extend to bioethics. Moral psychology signifi cantly supports actual-state, genealogical, and forward-looking analysis as well as restricted normative revision in bioethics. Second, though moral psychology may be used for unrestricted normative revision in metaethics (to wit, it may prompt change in entire moral frame-works without presupposing moral claims), bioethics must fi rst develop or adopt a suitable epistemic framework to make this use of the moral psychology that is available.
References
Antiel R.M., Humeniuk K.M., Tilburt J.C. (2014), “Spanning our Differences: Moral Psycholo-gy, Physician Beliefs, and the Practice of Medicine,” Philosophy, Ethics, and Humanities in Medicine 9 (1): 1–7.
Arras J.D. (1991), “Getting Down to Cases: The Revival of Casuistry in Bioethics,” The Journal of Medicine and Philosophy 16 (1): 29–51.
Baker R. (2002), “From Metaethicist to Bioethicist,” Cambridge Quarterly of Healthcare Ethics 11 (4): 369–379.
Beauchamp T.L., Childress J.F. (2013), Principles of Biomedical Ethics, Oxford University Press, New York.
Beauchamp T.L., Rauprich O. (2016), “Principlism,” [in:] Encyclopedia of Global Bioethics, H. ten Have (ed.), Springer, Berlin: 2282–2293.
Berker S. (2009), “The Normative Insignifi cance of Neuroscience,” Philosophy & Public Affairs 37 (4): 293–329.
Beschorner T. (2006), “Ethical Theory and Business Practices: The Case of Discourse Ethics,” Journal of Business Ethics 66 (1): 127–139.
Bloom P. (2004), Descartes’ Baby: How the Science of Child Development Explains what Makes us Human, Basic Books, New York.
Borry P., Schotsmans P., Dierickx K. (2005), “The Birth of the Empirical Turn in Bioethics,” Bioethics 19 (1): 49–71.
Brandt R.B. (1944), “The Signifi cance of Differences of Ethical Opinion For Ethical Rationa-lism,” Philosophy and Phenomenological Research 4 (4): 469–495.
Brinchmann B.S., Nortvedt P. (2001), “Ethical Decision Making in Neonatal Units: The Nor-mative Signifi cance of Vitality,” Medicine, Health Care and Philosophy 4 (2): 193–200. Buchanan A., Powell R. (2015), “The Limits of Evolutionary Explanations of Morality and
Their Implications for Moral Progress,” Ethics 126 (1): 37–67.
Callahan D. (1973), “Bioethics as a Discipline,” The Hastings Center Studies 1 (1): 66–73. Campbell R., Kumar V. (2012), “Moral Reasoning on the Ground,” Ethics 122 (2): 273–312. Chase S.B. (ed.) (1968), Problems in Public Expenditure Analysis, Brookings Institution,
Wa-shington, DC.
Childress J.F. (2007), “Methods in Bioethics,” [in:] The Oxford Handbook of Bioethics, B. Stein-bock (ed.), Oxford University Press, Oxford: 15–45.
Clarke S., Savulescu J., Coady C.A.J., Giubilini A., Sanyal S. (eds.) (2016), The Ethics of Human Enhancement: Understanding the Debate, Oxford University Press, Oxford.
Clipsham P. (2014), “Does Empirical Moral Psychology Rest on a Mistake?,” Philosophical Studies 170 (2): 215–233.
Clouser K.D., Gert B. (1990), “A Critique of Principlism,” The Journal of Medicine and Philo-sophy 15 (2): 219–236.
Cohen G.A. (2003), “Facts and Principles,” Philosophy & Public Affairs 31 (3): 211–245. Curry O.S. (2016), “Morality as Cooperation: A Problem-Centred Approach,” [in:] The
Evo-lution of Morality, T.K. Shackelford, R.D. Hansen (eds.), Springer, Dordrecht: 27–51. Doris J.M., Stich S., Philips J. et al. (2020), “Moral Psychology: Empirical Approaches,” [in:] Stanford Encyclopedia of Philosophy (Spring 2020 Edition), E.E. Zalta (ed.), URL = ht-tps://plato.stanford.edu/entries/moral-psych-emp/ [Accessed 29.06.2020]. Dörries A. (2009), “The 4-Step Approach: Ethics Case Discussion in Hospitals,” Diametros
Draper H. (2019), “Activism, Bioethics and Academic Research,” Bioethics 33 (8): 861–871. Draper H., Moorlock G., Rogers W. et al. (2019), “Bioethics and Activism,” Bioethics 33 (8):
853–856.
Duke G., Thompson S. (2007), “Knowledge, Attitudes and Practices of Nursing Personnel Re-garding Advance Directives,” International Journal of Palliative Nursing 13 (3): 109–115. Düwell M. (2013), Bioethics: Methods, Theories, Domains, Routledge, London.
Ebbesen M., Pedersen B.D. (2007), “Using Empirical Research to Formulate Normative Ethical Principles in Biomedicine,” Medicine, Health Care and Philosophy 10 (1): 33–48. Frodeman R., Briggle A. (2016), Socrates Tenured: The Institutions of Twenty-First-Century
Philosophy, Rowman & Littlefi eld, London, Lanham, Maryland.
Frodeman R., Briggle A., Holbrook J.B. (2012), “Philosophy in the Age of Neoliberalism,” Social Epistemology 26 (3–4): 311–330.
Frodeman R., Klein J.T., Mitcham C. (eds.) (2010), The Oxford Handbook of Interdisciplinarity (1. ed.), Oxford University Press, Oxford.
Greene J.D. (2008), “The Secret Joke of Kant’s Soul,” [in:] Moral Psychology Vol. 3: The Neu-roscience of Morality: Emotion, Disease, and Development, W. Sinnott-Armstrong (ed.), MIT Press, Cambridge, MA: 35–79.
Greene J.D. (2014), “Beyond Point-and-Shoot Morality: Why Cognitive (Neuro)Science Mat-ters for Ethics,” Ethics 124 (4): 695–726.
Greene J.D., Sommerville R.B., Nystrom L.E. et al. (2001), “An fMRI Investigation of Emotio-nal Engagement in Moral Judgment,” Science 293 (5537): 2105–2108.
Haidt J. (2001), “The Emotional Dog and Its Rational Tail: A Social Intuitionist Approach to Moral Judgment,” Psychological Review 108 (4): 814–834.
Harman G. (1977), The Nature of Morality: An Introduction to Ethics, Oxford University Press, Oxford.
Herrera C. (2008), “Is it Time for Bioethics to go Empirical?,” Bioethics 22 (3): 137–146. Horgan T., Timmons M. (eds.) (2006), Metaethics after Moore, Oxford University Press, Oxford. Hopster J. (2018), “Evolutionary Arguments Against Moral Realism: Why the Empirical
Details Matter (and which Ones do),” Biology & Philosophy 33 (41).
Ives J., Draper H. (2009), “Appropriate Methodologies for Empirical Bioethics: It’s all Rela-tive,” Bioethics 23 (4): 249–258.
Jenni K.E., Loewenstein G. (1997), “Explaining the ‘Identifi able Victim Effect’,” Journal of Risk and Uncertainty 14 (3): 235–257.
Jonsen A.R. (2003), The Birth of Bioethics, Oxford University Press, Oxford.
Jonsen A.R., Toulmin S.E. (2012), The Abuse of Casuistry: A History of Moral Reasoning, Uni-versity of California Press, Brekeley.
Joyce R. (2016a), “Evolution, Truth-Tracking, and Moral Scepticism,” [in:] R. Joyce, Essays in Moral Skepticism, Oxford University Press, Oxford: 142–158.
Joyce R. (2016b), Essays in Moral Skepticism, Oxford University Press, Oxford. Kahane G. (2011), “Evolutionary Debunking Arguments,” Noûs 45 (1): 103–125. Kass L.R. (1997), “The Wisdom of Repugnance,” The New Republic, June 2: 17–26.
Kay M., Matuszek C., Munson S.A. (2015), “Unequal Representation and Gender Stereotypes in Image Search Results for Occupations,” [in:] CHI ‘15: Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems, B. Begole, J. Kim, K. Inkpen et al. (eds.), The Association for Computing Machinery, New York: 3819–3828. Keane W. (2016), Ethical Life: Its Natural and Social Histories, Princeton University Press,
Kelly D. (2011), Yuck!: The Nature and Moral Signifi cance of Disgust, MIT Press, Cambridge, MA. Klenk M. (2018), Survival of Defeat: Evolution, Moral Objectivity, and Undercutting, Quaestiones
Infi nitae, Utrecht.
Klenk M. (2019a), “Objectivist Conditions for Defeat and Evolutionary Debunking Argu-ments,” Ratio 32 (4): 246–259.
Klenk M. (2019b), “The Infl uence of Situational Factors in Sacrifi cial Dilemmas on Utilitarian Moral Judgments,” SSRN Electronic Journal, URL = https://papers.ssrn.com/sol3/ papers.cfm?abstract_id=3501289 [Accessed 25.06.2020].
Klenk M. (2020a), “Change in Moral View: Higher-Order Evidence and Moral Epistemolo-gy,” [in:] Higher-Order Evidence and Moral Epistemology, M. Klenk (ed.), Routledge, New York: 1–27.
Klenk M. (2020b), “Third Factor Explanations and Disagreement in Metaethics,” Synthese 197 (1): 427–446.
Klenk M. (ed.) (2020c), Higher-Order Evidence and Moral Epistemology, Routledge, New York. Kon A.A. (2009), “The Role of Empirical Research in Bioethics,” The American Journal of
Bio-ethics 9 (6–7): 59–65.
Leiter B. (2004a), “The Hermeneutics of Suspicion: Recovering Marx, Nietzsche, and Freud,” [in:] The Future for Philosophy, B. Leiter (ed.), Clarendon Press, Oxford: 74–105. Leiter B. (ed.) (2004b), The Future of Philosophy, Clarendon Press, Oxford.
Lindauer M. (2019), “Experimental Philosophy and the Fruitfulness of Normative Concepts,” Philosophical Studies, Published 08 May 2019, DOI: https://doi.org/10.1007/s11098-019-01302-3.
Lindemann H. (2019), “Bioethicists to the Barricades!,” Bioethics 33 (8): 857–860.
May J. (2016a), “Emotional Reactions to Human Reproductive Cloning,” Journal of Medical Ethics 42 (1): 26–30.
May J. (2016b), “Repugnance as Performance Error: The Role of Disgust in Bioethical In-tuitions,” [in:] S. Clarke, J. Savulescu, C.A.J. Coady et al. (eds.), The Ethics of Human Enhancement: Understanding the Debate, Oxford University Press, Oxford: 43–57. Musschenga A.W. (2005), “Empirical Ethics, Context-Sensitivity, and Contextualism,” The
Journal of Medicine and Philosophy 30 (5): 467–490.
Paulo N. (2019), “In Search of Greene’s Argument,” Utilitas 31 (1): 38–58.
Prinz J.J. (2007), The Emotional Construction of Morals, Oxford University Press, Oxford. Ruse M., Wilson E.O. (1986), “Moral Philosophy as Applied Science,” Philosophy 61 (236):
173–192.
Schelling T.C. (1968), “The Life You Save May Be Your Own,” [in:] Problems in Public Expen-diture Analysis, S.B. Chase (ed.), Brookings Institution, Washington, DC: 127–167. Shackelford T.K., Hansen R.D. (eds.) (2016), The Evolution of Morality, Springer, Dordrecht. Shafer-Landau R. (ed.) (2018), Oxford Studies in Metaethics: Volume 13, Oxford University
Press, Oxford.
Sinclair N. (2018), “Belief-Pills and the Possibility of Moral Epistemology,” [in:] Oxford Stu-dies in Metaethics 13, R. Shafer-Landau (ed.), Oxford University Press, Oxford: 1–41. Singer P.A., Viens A.M. (2008), The Cambridge Textbook of Bioethics, Cambridge University
Press, Cambridge.
Sinnott-Armstrong W. (2006), “Moral Intuitionism Meets Empirical Psychology,” [in:] Metaethics after Moore, T. Horgan, M. Timmons (eds.), Oxford University Press, Oxford: 340–366. Sinnott-Armstrong W. (ed.) (2008), Moral Psychology: The Neuroscience of Morality: Emotion,
Steinbock B. (ed.) (2007), The Oxford Handbook of Bioethics, Oxford University Press, Oxford. van Thiel G.J.M.W., van Delden J.J.M. (1997), “Dealing with Patient Autonomy in Dutch
Nursing Homes,” Health Care in Later Life 3: 177–186.
Veatch R.M. (1981), A Theory of Medical Ethics, Basic Books, New York.
Vries R. de, Gordijn B. (2009), “Empirical Ethics and its Alleged Meta-Ethical Fallacies,” Bioethics 23 (4): 193–201.
Wielenberg E.J. (2016), “Ethics and Evolutionary Theory,” Analysis 76 (4): 502–515.
Wocial L.D. (2010), “Nurturing the Moral Imagination: A Refl ection on Bioethics Education for Nurses,” Diametros 25: 92–102.
Żuradzki T. (2019), “The Normative Signifi cance of Identifi ability,” Ethics and Information Technology 21 (4): 295-305.
Żuradzki T. (2015), “The Preference Toward Identifi ed Victims and Rescue Duties,” The American Journal of Bioethics 15 (2): 25–27.
